Arizona Center for Integrative Medicine

Transcript

Dr. Victoria Maizes
Hi, Andy.

Dr. Andrew Weil
Hi Victoria.

Dr. Victoria Maizes
Today we will be interviewing Koshin Paley Ellison who is a Buddhist teacher and actually a regular teacher of our fellows.

Dr. Andrew Weil
So this will be a bit of a different conversation from our usual guests. And I have always really enjoyed Koshin so I can't wait to hear him.

Dr. Victoria Maizes
Let's welcome him.


Intro Music

Dr. Victoria Maizes
Koshin Paley Ellison is an author, Zen teacher, Jungian psychotherapist and certified chaplaincy educator. He co-founded the New York Zen Center for Contemplative Care. Cushion is the author of two books, Untangled and Wholehearted, as well as the coeditor of Awake at the Bedside. His work has been featured in The New York Times, PBS, CBS, Sunday Morning and Tricycle. Welcome.

Koshin Paley Ellison
Thank you. It's such a joy to see you both.

Dr. Victoria Maizes
I love the title of your book, Untangled. You say the tangle is all the ways we bind ourselves up in fear uncomfortable stories and self-created clouds of confusion. And we do this, ironically, to seek happiness. How do we get ourselves in this mess? And what does Zen Buddhism suggest that we can do to extract ourselves?

Koshin Paley Ellison
Hmm. Well, I think that one of the main causes of this entanglement is being born. And we have this habit of getting into trouble because we want what we want when we want it. We get impatient, we get difficult. We get resentful. We hold on to stories We forget that we belong to each other.

And so we don't behave in ways that actually connect us. And so we get ensnared in this tangle of separateness, of our resentments and our greed. And so we forget that kindness and connection are available. And so to me, one of the beautiful ways of just remembering is learning how to actually pause and raise our eyes up and to realize, “oh, you matter and I matter, and we're here together, which is a rare thing.”

And I just think about all of the ways that we hurt ourselves in some ways by withdrawing not that there's anything wrong with withdrawing, but just kind of we can withdraw too much. And in the same way that we can open too much. And I think it's always learning how to balance and learning how to take a moment to pause and connect.
Dr. Victoria Maizes
Hmm. So beautiful. You mentioned our less helpful stories, actually. Your book Untangled is full of teaching stories, some difficult ones from your own life, which I really appreciated your vulnerability in sharing them. But then in Zen Buddhism, there are these very odd teaching stories called koans. What's their purpose? And do you have a favorite?

Koshin Paley Ellison
Yeah, well, koans are what they actually mean as a public care, so it's often like a recording of like, “Oh, you remember that story of like when I was at the dining room with you, Victoria, and you said this and I said that, and then someone records that and says, What do you think?” And they're often designed to help us to get out of our conceptual thinking.

So oftentimes I think they're misunderstood as riddles, but they're actually ways to make ourselves a bit more present and lively in the moment. I was thinking about this beautiful koan that I love, it's called Zen Master Xie gone, and he used to just walk around and say to himself, “Are you awake?”

And he would respond to the same question, say, “Yes, I am.” And then he would say, “Never be deceived.” And he says, “No, I won't.” And that's the whole koan. Uh huh. And so you're supposed to when you're working with the teacher, then you express that some your own version of that, your own, you know, beautiful, eccentric expression of that.

And the reason I love this koan much is that it's such a beautiful remembering that it's up to us to wake up. And sometimes we have to be like, “Hello, hello, Hello. Are you here now? Are you here?” And wow, because we can get so clouded. And so that one has been super important
for me, and especially as a young person, really trying to figure out how to get out of the clouds of my own distraction, out of my own heart and out of my own stories that I've been holding on too long to.

And the second part of it to me is super interesting, where he says, you know, “and don't be deceived” and how we deceive ourselves and thinking, I'm not you. And we think that our story is true. We think that our feelings are true. We think that so many things are true as opposed to just the experience itself. So one other one comes to mind really quickly.

So like, there's these two monks and so these two guys are just like walking along and they run into this woman and she wants to cross the stream, but it's kind of swiftly moving this sort of a famous Zen story and they she says, “you know, can one of you help me?” And they're like, “oh no, we're not supposed to do that.”

And we're not supposed to be, you know, associating or hold touching women or something. And one of the monk was like, sure, I can help you. And just like, you know, as my grandmother would say, kind of mangy and just like, puts her on his back, brings her across the river. And then a couple of days later, the other monk is like, “Hey, you know, I can't believe you did that, you jerk.”

You know, we weren't supposed to do that. And it's like, What are you talking about? It's like, that woman is like, I put her down days ago. How about you? Yeah.

Dr. Victoria Maizes
You're still carrying her?

Koshin Paley Ellison
Yeah.

Dr. Andrew Weil
Koshin you talk a lot about compassion. What is compassion? How do we develop it and what is its relevance in medicine.

Koshin Paley Ellison
Yeah, it's such a beautiful and important thing. So most of us, I think, are deeply empathic people, which in how I understand that is just empathy is that neutral capacity that you feel one another and like you're walking on the street and you feel like, “oh they're angry” and you can just feel it in their body. And compassion is what we can do with that.

And so to me, it's the compassion is the action, the compassionate action that we work with that and for me, good medicine is compassion. You know, I was thinking about, you know, yesterday Chodo is my husband and we're sitting with these two people that we've had the pleasure of being with in their last moments of their now they both have a terminal diagnosis.

A mother and daughter, so beautiful. One has a end stage COPD, COPD, and the other one has cancer and they're taking care of each other. It's so amazing. And I was we were talking about compassion yesterday and the mother said, “well, it's this it's what we're doing. And it was what helps me remind myself that it's not about an hour from now, it's about what's between here and there.”

And she touched her daughter's hand. So beautiful. And it was such a wonderful reminder about the importance of it, because you can get caught up and I know I can. And like what I'm supposed to do or not wanting to feel, you know, hopeless or helpless, but just to be sitting in this situation where they both know there's nowhere to go.

And so compassion to me is that warming in the space and the warming it means to suffer with or to feel where is the most generous thing we can do. Or as the beautiful mother said, you know, from here to there.

Dr. Victoria Maizes
That's such a wonderful and heartwarming story. And it strikes me that your work, of course, is to bring compassion more deeply into the world, into health care. And yet health care right now feels often like the opposite of the quality you just described. What do you think we can do to make health care more compassionate?

Koshin Paley Ellison
Well, I think what we can do is get together more and create more loving space together. To me, it's like the pleasure of what the two of you are doing with this beautiful integrative medicine fellowship. I mean, to me, it's like that, those kind of circles. I think about our our dear Bodisfa brother who died, you know, Albert Einstein, he was called and he said, you know, that our work is to extend the circles of compassion.

So I think by creating circles like the Integrative Medicine Fellowship and which Chodo and I just love being part of, and also our contemplative medicine fellowship, and these are ways of that. We need more circles where we can actually be together and the world has such a need. And there's as we know, that there was a loneliness pandemic long before the COVID 19 pandemic.

And so all the different ways the world needs for us to remember that we matter and that showing up and actually maintaining circles of compassion to me is exactly what's needed in this world and to remember what medicine is like, what is medicinal, what is actually what's good medicine is the two of you teach all the time about.

Koshin Paley Ellison
And it's so extraordinary to me, it's like we need those voices all the time to write, to remember, to remember. Yeah.

Dr. Andrew Weil
You know, I think there's a practical problem, though, for some doctors that if you're too compassionate, you can be overwhelmed by identification with the suffering of patients and doctors I often here have to screen that out or shut themselves off because otherwise they lose their center.

Koshin Paley Ellison
Yeah, I hear that all the time, too. And, you know, I but my experience is over time that, you know, it just was talking to a physician the other day who were saying that they went to this very progressive medical school because they thought there would be, a different approach. And there were.

Dr. Andrew Weil
Is there such a thing? I'm not sure.

Koshin Paley Ellison
That's a great question. It was. And she was told like, oh, well, you know, turn off your feelings. They'll come back eventually. Hmm. Wow. Wow. And and they were saying, you know, it's been 15, 20 years now and it still hasn't come back. And so that and what I experience there was this really interesting study I'm terrible at remembering names of studies or dates.

But there was a study in Canada of hospice workers actually self-described as compassionate and feeling their patients and they were much more resilient. They would go back to their baseline very quickly. And the physicians and clinicians who describe like kind of trying to, as you're describing, kind of like, I don't have time for that.

No, thanks were the ones who had burnout, the other key part of that study was that the people who were describing themselves as compassionate would feel really deeply. You know, they would get so sad, but then they would go back to their baseline. But the people who are trying to thwart that would just it's almost like trying to keep a beach ball under the water.

You know, eventually it's going to pop up in your face. You know, it's like it's not tenable, right?

Dr. Victoria Maizes
I remember feeling very much like going through my medical training was an armoring process. And the problem with armor is it can become very hard to take off. And one thing that I found really beautiful in Untangle was a meditation that you share called Opening the Cage. And I'm wondering whether you would take our listeners through this.
I would say if anyone's driving, maybe listen to this later, though.

Koshin Paley Ellison
Yeah, I'd be happy to. You know, just a little background is that I too, as a young person, experience lots of very challenging experiences of sexual violence and physical violence. so that armor was so important.

Dr. Victoria Maizes
MM.

Koshin Paley Ellison
And anti-Semitic violence, like, it was just, it was really like a gantlet of difficulty. And for a long time I had identified as kind of a victim of those things. Mm hmm. And that's where, like, what was part of the armor, too was that identity as like, I'm a victim of those things. And what I started to realize is, oh, my goodness, it's heavy, as you were saying, and difficult.
And it had begun and began to feel like a cage. Mm hmm. And so that very thing that protected me for so long, even that identity no longer served me. Those things did happen, and there were terrible things, but I was no longer needing to be a victim of it. So I started to see like, “Oh, how can that openness this cage.” this armor had turned into a cage.

And so I'd be happy to guide us through it, It's quite simple. So just take a moment to adjust your posture and just see if you can ground yourself and allow your belly to be a little bit softer, even a tiny bit, your shoulders to be a little bit open. And just imagining that you're in a cage that is the size of your own body just to like maybe a half an inch away from your body. In the front of the cage of your body is all the things that you know that are keeping you trapped in things that you know about your story, that have been difficult, that you're holding on to, and allow that to open what it'd be like to not have that right in front of you, in front of your face and your heart around your belly.

Just notice what that feels like and then noticing on the sides of your body that those are the things you kind of know you're a little aware of that are kind of holding you and hemming you in. Maybe what you fear will happen and allow those to open the sides of your fears, allow that to fall away. There is still, you know, part of the cage remains, which is the back which, as Carl Jung called it, the shadow that we don't know and will carry with us something that we can always wonder about.

And yet, because the front and sides are no longer holding us back, we can still walk with ease, breathe with ease and move.

So appreciating what was one's armor for what it has done for you and allow yourself to be here and this moment feeling free and feeling clear and spacious.

Dr. Victoria Maizes
That was so lovely. You know, Andy and I have a colleague, Joan Halifax. I'm sure she's your friend. Colleague as well. And one thing that I heard her say many years ago that really helped me with the sense of armoring is she said “just four words, soft belly, strong spine.” You know, we need a certain amount of structure, obviously, to carry us through, especially, I would say, the challenging world that we live in at times.

And yet, like you say, if you're completely armored, it's it's a burden.

Dr. Andrew Weil
Koshin you have a good sense of humor. And my observation of you when you've come out to teach with us is that you laugh, you're happy. Humor is important to you. But Zen has a reputation for being very severe and humorless. And I have certainly known a number of very serious Zen practitioners who seem to be quite devoid of humor.

And I wonder how you reconcile that and what importance you place on humor.

Koshin Paley Ellison
Well, life is so short but the joy of living is always available there is some kind of form of strictness and a lack of humor in the tradition, I would say. And I think that there are also many wonderful, very joyful, like there's this one monk in Rio Kahn, who is just like this, often known as the great fool.

And he's a wonderful hero of mine. And he'd like just to play with children and play ball and go into town and write poems. And people made fun of him and he was like, That's totally fine. You know, he just felt that this incredible joy and for me. But the work is so serious, you know, medicine and Zen practice and dealing with people suffering with our own suffering is so serious.

And to be serious on top of that feels crazy, you know, and there are some actually koans that says, please don't add another head on top of your head. You know, it's so to me, it's a great kindness to realize that life is also very joyful. And I experience life is incredibly joyful, which I never would have imagined as a young boy.

And to me is really from going through the difficulty and you come through it and you're like, wow.

Dr. Andrew Weil
Some years ago, I visited a rare Zen temple in Shanghai that was practicing. I was in the courtyard of this temple, and a procession of monks came out looking incredibly humorless and serious. And there was a long line. And then at the very end, there was the master of the temple who was a fat, jolly monk who was laughing and tossing his head around. And it was just wonderful to see.

Koshin Paley Ellison
It's so important. And I think that in general it's good. Think about in medicine, in a life like that, life is so short. And, you know, we often talk about, you know, the ends and, you know, that life and death are supreme importance and time swiftly passes by and opportunities are lost. So we must awaken and to me, one of the ways of awakening is through humor. And I think it was definitely through my Jewish grandparents who are very funny.

Dr. Andrew Weil
My mother always said that you must never lose your sense of humor. She said, “It's important to always to see the ridiculous side of life.”

Koshin Paley Ellison
Totally. I mean, I remember when my grandmother was in hospice, sometimes somebody would come in and she would like I remember I think the chaplain came in and he came into the doorway and she said, There she is dying. And he says, “Mrs. Ellison, you know, my I'll be praying for you.” And she's like, “I'll be praying for him, too.” You know?

You know? So it's just like sometimes in these moments where, you know, yes, I think it was really her. My grandma made me who just like, really taught me so much about humor. You know, one night, actually, as she was dying, she was like, Tonight's the night gather, everyone around. I'm going to die tonight. And they're all like, sitting around and she's sitting stoically in her bed.

And she kept looking down at her watch and like and then she was like, around like, 10:30. It's just like, “listen, it's not going to happen. Let's order some pizzas.”

Dr. Victoria Maizes
So I wonder if you can carry this into meditation because and I'd love to ask both of you this question. Meditation is difficult for many people. And it's not only difficult, I would say, to get started, it's actually maybe even more difficult to maintain. It's kind of like weight loss, huh? And I'm wondering whether you have a tip, one to get started and two how to maintain. And then three, is there a way to bring humor into a meditation practice?

Koshin Paley Ellison
Andy. Rock, paper, scissors.

Dr. Andrew Weil
One trick is to remind yourself that on some level you are always meditating. You know, there's a part of the mind that is always in meditation, and that's not where most of us put our attention. But knowing that that's inside you, that helps. Another just practical tip, I find if I don't do meditation when I first get up, I tend not to do it.

So for me, morning time that transitional state between sleeping and waking. And that's ideal for me. And as for maintaining it, I think that's just a matter of, it's a ritual that you do just like brushing your teeth or doing some physical activity, you know.

Koshin Paley Ellison
So I would say two similar things. Well, first of all, there was another study that is I'm going to uncited and but I just remember, like I think it was in the eighties and people stopped meditating because they didn't feel better. So meditation is not really designed to make you feel better as opposed to, as I understand it, trying to actually support you, being courageous to be where you are.

And most of us don't necessarily like where we are. So I think it's really important. And to remember, I think also and what you're saying, the discipline is actually what sets you free. In my experience, and most of us think like, “oh, you know, Freebird, like I want to just like, do my own thing” is freedom. I find freedom through discipline, enrich all.

Actually, to me, I have such a specific morning where I get up and have some matcha and then I go and work out and then I sit with our community for a half an hour. And to me it's like that. And I have a delicious breakfast. And then I hold Chodo’s face. And then I had head out. And that to me, it's I'm quite disciplined at that.

And it feels like when I do that each morning, I feel so ready to meet the day. And so to me, sometimes not believing what we want and what we prefer, but actually what truly feels nourishing.

Dr. Victoria Maizes
Those are wonderful answers. I want to go back to the koan that you cited earlier. Am I awake? And you actually have talked at some moment about maybe this is a simulation?

How do we know if we're awake?

Dr. Andrew Weil
Well, I'm not an expert on that. I'm listening to what Elon Musk says, that we're certainly in a simulation. It's an interesting idea to me. I don't know that we could ever know that, another vs another thought that I that I have is that, you know, I am a pan psychist. I believe that consciousness is primary and pervades everything.

And I think that consciousness organizes matter into more and more complex forms to know itself. And maybe we eventually evolve towards, you know, being all knowing that that's part of this strange process that we're in.

Dr. Victoria Maizes
Do you feel like you're getting close to all knowing? Isn't that enlightenment?

Dr. Andrew Weil
Maybe that's what we find out when we die.

Dr. Victoria Maizes
How about you Koshin, how do we know if we're awake?

Koshin Paley Ellison
It's to me, there's these glimpses that we have when we're. To me, it's like I was talking about this yesterday yesterday there was this heavy rains in New York City and, you know, there is a lot of dog shit, you know, and lot and like, you know, and it's have heavy rains. It's hard for people to pick it up.

And so, like, there was just like this, it was bright yellow dog shit on the sidewalk. And it was I just looked at it and notice for a moment like a little preference about it. And I just like, Wow, it's actually kind of like kind of beautiful. The color of it was beautiful. And next to it were these white and dahlias.

Yeah. And it was just it actually took my breath away, this yellow.

It was just beautiful in a weird. Yeah, beautiful moment. And to me, it was just like, I just remember kind and it's just wonderful. And I think sometimes we have this idea of what awakeness is, and we think it's like that woman in the bathing suit on the cover of Time magazine, you know, at the beach, you know.

But I think it's in the midst of our ordinary life. And it kind of reminds me of, like those two women I was with yesterday who were just like, oh, it's the space between us, you know, It's like that when you realize it's nothing else other than those two laps right over there. And I'm here. Yeah.

Dr. Victoria Maizes
That makes me think of something else that I've heard you speak about, which is maybe another definition of a weakness, which is a full engagement with life. And I feel like the zeitgeisty right now is the opposite of that. It's distracted busyness. What do you think we could do to stop being so busy and notice the beauty of yellow dog shit next to white azaleas?

Koshin Paley Ellison
Slow down, slow down. You know, what's the hurry? You know, And I think that, you know, we were talking earlier about, positions like saying, like, I don't have time for this. You know, I don't have time for it. But what we do have is actually all we have is time and what we do with the time.

So to me, it's always trying to remember like, oh, my goodness, like all I have is the time that I have. I remember going into the neuro ICU and there was a physician there who was helicoptered in as he was walking to his retirement party and he was dying. He had a bleed in his brain and they couldn't stop it and he was dying.

And so I was just comparing him and his wife and there's like, oh, we're going to after the retirement party, we're going to go on a cruise around the world and we're going to begin living animals, like, what was I doing for 40 years? He's like, Oh my goodness. So those minutes that we think we don't have time for meditate and we don't have time to stop and and just take in a face.

You know, like one of my favorite things to do is our centers here, Manhattan on 23rd Street has just like to notice people's faces is so amazing. And then you actually recognize the other people who are really walking and looking. You're like, well, look at you. You're looking, you're here too. And so I think it's really ordinary and we have to make in some way as a decision to put our phone away and put our mind right in front of us and through us.

And just like all good doctors. Yeah, I think I learned that from my grandma, too. She loved people's faces so much.

Dr. Victoria Maizes
Such beautiful stories. Thank you. Is there a final Koshin that you would like to share?

Koshin Paley Ellison
There's this really beautiful story that kind of goes out into silence where this teacher, you know, felt like he was visiting his his teacher and then they got talking and it was into the night and his teacher gave him a little glass candle thing and lit the candle and, and the student was very touched.

She's like, God, thank you so much. And so it was about to leave. And his teacher said, Oh, one, one last thing. And so he opened the candle thing and blew out the candle. Because he needed to go out into the dark and out into the silence of the night and to feel his way.

And so to me it's like, our great practice and great work is to do that. Sometimes where we do don't have the map, we don't have a candle, we don't never last like on our phone, but we can move our way into this world knowing that we're with each other.

Dr. Victoria Maizes
Yeah, well, thank you for your wisdom. Thank you for coming and teaching our fellows at the Andrew Weil Center for Integrative Medicine. Thank you for the beautiful work that you do in this world.

Koshin Paley Ellison
It's a privilege to be with you both and privileged to live. You know, one precious life we have.